Abstract
We report that adrenocorticotropic hormone (ACTH) protects against osteonecrosis of the femoral head induced by depot methylprednisolone acetate (depomedrol). This therapeutic response likely arises from enhanced osteoblastic support and the stimulation of VEGF by ACTH; the latter is largely responsible for maintaining the fine vascular network that surrounds highly remodeling bone. We suggest examining the efficacy of ACTH in preventing human osteonecrosis, a devastating complication of glucocorticoid therapy.
Publication types
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Research Support, N.I.H., Extramural
MeSH terms
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3T3 Cells
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Adrenocorticotropic Hormone / pharmacology
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Adrenocorticotropic Hormone / therapeutic use*
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Animals
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Apoptosis / drug effects
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Cell Differentiation / drug effects
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Cytoprotection / drug effects
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Female
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Femur / drug effects
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Femur / pathology*
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Glucocorticoids / adverse effects*
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Humans
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Mice
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Osteoblasts / drug effects
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Osteoblasts / metabolism
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Osteoblasts / pathology
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Osteoclasts / drug effects
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Osteoclasts / metabolism
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Osteoclasts / pathology
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Osteonecrosis / chemically induced*
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Osteonecrosis / drug therapy*
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Osteonecrosis / prevention & control
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Protective Agents / pharmacology
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Protective Agents / therapeutic use*
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Rabbits
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Vascular Endothelial Growth Factor A / biosynthesis
Substances
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Glucocorticoids
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Protective Agents
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Vascular Endothelial Growth Factor A
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Adrenocorticotropic Hormone